<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Nickname')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-nickname" class="form-control" name="row[nickname]" type="text" value="{$row.nickname|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">手机号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" class="form-control" name="row[mobile]" type="text" value="{$row.mobile|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">真实姓名:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-real_name" class="form-control " name="row[real_name]"  data-rule="required" value="{$middle.real_name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">银行卡号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-card_no" class="form-control " name="row[card_no]"  data-rule="required" value="{$middle.card_no|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">开户行:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bank_name" class="form-control " name="row[bank_name]"  data-rule="required" value="{$middle.bank_name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">易宝商户号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ledger_no" class="form-control " name="row[ledger_no]"  data-rule="required" value="{$middle.ledger_no|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">返点设置:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-rebate_amt" class="form-control " name="row[rebate_amt]"  data-rule="required" value="{$middle.rebate_amt|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">所属销售:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-salesman_admin_id" data-rule="required" class="form-control selectpicker" name="row[salesman_admin_id]" data-rule="required">
                <option value="">请选择</option>
                {foreach name="salesmanList" item="vo"}
                    <option value="{$vo.id}" {if $middle.salesman_admin_id==$vo.id}selected{/if}>{$vo.nickname}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
